Firefighters, Mental Health, and COVID-19

Empty streets, shuttered shops, and isolation from friends and family marked lockdowns during the COVID-19 pandemic. As schools and offices became off-limits, many people had to continue working, saving our lives by risking theirs. Many medical staff and emergency services workers never left the frontlines.

Scrambling to fulfil their duties in vastly changed circumstances—while knowing that they were risking infecting themselves, their colleagues, and their families—imposed mental health stress. We wanted to learn more about what they went through, to help them document their stories while assisting everyone in preparing for the next pandemic. Too many lives were lost, from COVID-19 and the lockdowns, despite decades of science on how to do better existing long before the new virus emerged.

Method

We interviewed eight senior firefighters in London, UK and nine in Bergen, Norway, enquiring about their mental health impacts and responses to the sudden pandemic-related changes in firefighting regulations and routines. What were their priorities as COVID-19 and lockdowns took hold? How did they adapt? What difference does leadership make? What might they recommend for preventing adverse mental health impacts and for providing support to deal with them?

This research was led by Jarle Eid, Professor of Work and Organizational Psychology, at the University of Bergen in Norway and Gianluca Pescaroli, Associate Professor in Operational Continuity and Disaster Resilience, at University College London in the UK. Bergen’s regional research fund, Regionalt forskningsfond (RFF) Vestland, provided the money. Research ethics approval was granted by the Norwegian Centre of Research Data and University College London.

The London Fire Brigade and our research team.

Ilan Kelman

Results

Within our wider project, we now have in-depth results and analyses for COVID-19. Four common themes emerged across both locations:

• Firefighters’ mental health was challenged, because their cities changed overnight to surreal landscapes, coupled with huge safety concerns regarding COVID-19 infection. Some firefighters resided in hotels to avoid close contact with their families. The high, intense workload led to physical and mental fatigue, with dominant emotions including loneliness, anxiety, and exhaustion.
• Operational readiness had to be maintained, leading to new routines and major adjustments for managing personnel and equipment. These actions were essential, yet added workload and mental health stress, particularly as shift changes required intensive disinfection of equipment and lacked the camaraderie of teams interacting.
• On a positive note, community support for firefighters increased with their service and actions being recognised and appreciated. Contact increased between senior leadership and junior firefighters. These gains continue today, highlighted by improved trust in each other and better understanding of command structures. One difficult aspect was decreased interaction with the public, such as events in schools and open days at fire stations.
• Other major advantages materialized in learning how to work and train remotely and digitally, augmenting professionalism and learning, which supported mental health. These gains continue today.

Recommendations

Overall, these experiences demonstrate how training and practice for flexibility and adjustment are more important than training and practice according to detailed plans. A balance between routine and swift pivoting from routine is needed to support mental health and operational readiness. After all, firefighters displayed amazing flexibility, coping, dedication, and ability to adjust, while admitting trauma from isolation, disconnection, and the threat of harming their families via COVID-19.

Leadership made a huge difference in supporting firefighters’ mental health in a crisis. Good leadership instilled confidence and commitment. Poor political leadership, such as not providing sufficient personal protective equipment, increased stress.

Too many long-standing lessons had not been implemented by decision-makers before it was too late. Firefighters perceived the COVID-19 pandemic as surprising, unpredictable, and unprecedented. Drawing on extensive, previous pandemic knowledge and experience would have better prepared them. An important approach is practising rapid, competent responses to a wide variety of scenarios, rather than developing detailed, manual-based, line-by-line instructions, which can produce tunnel vision.

Our study across two countries is comparatively unique, with few similar ones in the past. We hope that the patterns we identified and the documenting of real-life mental health during crisis will help to support and save the lives of emergency responders and all of us.